Er:YAG laser vs. sharp debridement in management of chronic wounds: Effects on pain and bacterial load
| Autor: | Eri Fukaya, Gretchen Dori, Babak Hajhosseini, Geoffrey C. Gurtner, Grace Chiou, Shannon Meyer, Venita Chandra |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Pilot Projects Lasers Solid-State Dermatology Pain Procedural Varicose Ulcer law.invention Bioburden 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law medicine Humans Aged Pain Measurement Aged 80 and over Alternative methods Pain score Cross-Over Studies business.industry Patient Preference Middle Aged Crossover study Patient preference Bacterial Load Diabetic Foot Surgery Treatment Outcome Debridement Debridement (dental) Chronic Disease Wounds and Injuries Female Laser Therapy business Er:YAG laser |
| Zdroj: | Wound Repair and Regeneration. 28:118-125 |
| ISSN: | 1524-475X 1067-1927 |
| DOI: | 10.1111/wrr.12764 |
| Popis: | Chronic wounds affect roughly 6.5 million patients in the US annually. Current standard of therapy entails weekly sharp debridement. However, the sharp technique is associated with significant pain, while having minimal impact on the bioburden. Our study proposes the Er:YAG laser as an alternative method of debridement that may decrease procedural pain, reduce bioburden, and potentially improve overall healing. This pilot study was performed as a prospective, randomized, controlled, crossover clinical trial, containing two groups: (1) one group underwent single laser debridement session first, followed by single sharp debridement session one week later; and (2) the other group underwent single sharp debridement session first, followed by single laser debridement session one week later. Variables analyzed included pain during debridement, pre- and post-debridement wound sizes, pre- and post-debridement bacterial loads and patient preference. Twenty-two patients were enrolled (12 patients in Group 1, plus 10 patients in Group 2). The mean pain score for patients undergoing laser debridement was 3.0 ± 1.7 vs. 4.8 ± 2.6 for those undergoing sharp debridement (p = 0.003). The mean percent change in wound size 1-week post-laser debridement was -20.8% ± 80.1%, as compared with -36.7% ± 54.3% 1-week post-sharp debridement (p = 0.6). The percentage of patients who had a bacterial load in the low/negative category increased from 27.3% to 59.1% immediately after laser debridement (p = 0.04), vs. 54.5% to 68.2% immediately after sharp debridement (p = 0.38). Moreover, there was a sustained decrease in bacterial load 1-week post-laser debridement, as compared with no sustained decrease 1-week post-sharp debridement (p < 0.02). Overall, 52.9% of patients preferred laser debridement vs. 35.3% for sharp debridement. We believe that Er:YAG laser serves as a promising technology in chronic wounds, functioning as a potentially superior alternative to sharp debridement, the current standard of therapy. |
| Databáze: | OpenAIRE |
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